Tue, January 17, 2023
Wade Smith is the owner of Smith's Ambulance Services.
(Patrick Butler/Radio-Canada
An ambulance operator in Whitbourne says the already stretched paramedic system will be stretched even further if a strike ignites between the more than 100 employees of seven private ambulance companies and owner Bob Fewer.
"If there is an emergency and we do have something available that we can send in close proximity that would benefit the person, we would respond," Wade Smith, owner of Smith's Ambulance Services in Whitbourne, told CBC News on Monday.
"But the thing is, that's going to stress our staff out. Our staff works 24 hours. Once our staff start doing calls like that, and we look at 'OK your fatigue time is up' then we have to take that full crew off. We can't respond to anything."
Wade wonders if that scenario actually happens, who will respond to emergency calls in his coverage area.
He said he doesn't see any signs of relief right now.
The provincial government has said its regional health authorities will work with private ambulance services, will bring on additional staff to support emergency responses with routine transfer services and will also "activate additional RHA ambulances," in response to a possible disruption.
"If ambulance services are required, residents of the region are directed to call 911. N.L. 911 has been made aware of the potential change in service and is ready to redirect calls to the appropriate provider," reads a statement from Debbie Marnell, a provincial government communications director, last week.
The over 100 employees facing a possible strike began a work-to-rule campaign on Wednesday, meaning they perform only their core job functions.
The union representing the workers — Teamsters Local 855 — said the campaign is the first step in the strike plan, though ambulance services haven't been disrupted yet.
Jeremy Eaton/CBC
Hubert Dawe, the business agent for Teamsters Local 855, also wonders where the resources will come from if his members strike.
He calls the province's statement misleading.
"The reality is we have ambulances that have been allocated in these contracts private operators have with the government that have been parked because there's physically nobody to sit aboard those ambulances and to make those ambulances work," Dawe told CBC News.
"I really and truly don't know where these paramedics are coming from. If the government has them in their back pocket, please let them out, it would help the situation greatly right now."
CBC News asked the Department of Health where the additional staff will come from, what roles they would fill, the capacity of adjacent ambulance services to fill gaps elsewhere and how many additional ambulances to RHAs have.
The Health Department said contingency plans were developed by the regional health authorities and they would be better suited to answer any inquiries relating to operations.
In a statement to CBC News, Central Health communications director Gayle St. Croix said Central Health and Eastern Health have contingency plans in place to help mitigate any job action impact.
"Mutual aid is often provided when ambulances are out of a service area by other private and community operators that are not involved in this job action. This is expected to continue as per regular processes," the statement reads.
"RHAs can also provide support internally when an ambulance is out of a service area, within available human and ambulance resources. The number of additional available ambulances within the RHAs is variable depending on the region, time of day and staff availability. RHAs will assess whether any support can be provided following established processes."
NB
An ambulance operator in Whitbourne says the already stretched paramedic system will be stretched even further if a strike ignites between the more than 100 employees of seven private ambulance companies and owner Bob Fewer.
"If there is an emergency and we do have something available that we can send in close proximity that would benefit the person, we would respond," Wade Smith, owner of Smith's Ambulance Services in Whitbourne, told CBC News on Monday.
"But the thing is, that's going to stress our staff out. Our staff works 24 hours. Once our staff start doing calls like that, and we look at 'OK your fatigue time is up' then we have to take that full crew off. We can't respond to anything."
Wade wonders if that scenario actually happens, who will respond to emergency calls in his coverage area.
He said he doesn't see any signs of relief right now.
The provincial government has said its regional health authorities will work with private ambulance services, will bring on additional staff to support emergency responses with routine transfer services and will also "activate additional RHA ambulances," in response to a possible disruption.
"If ambulance services are required, residents of the region are directed to call 911. N.L. 911 has been made aware of the potential change in service and is ready to redirect calls to the appropriate provider," reads a statement from Debbie Marnell, a provincial government communications director, last week.
The over 100 employees facing a possible strike began a work-to-rule campaign on Wednesday, meaning they perform only their core job functions.
The union representing the workers — Teamsters Local 855 — said the campaign is the first step in the strike plan, though ambulance services haven't been disrupted yet.
Jeremy Eaton/CBC
Hubert Dawe, the business agent for Teamsters Local 855, also wonders where the resources will come from if his members strike.
He calls the province's statement misleading.
"The reality is we have ambulances that have been allocated in these contracts private operators have with the government that have been parked because there's physically nobody to sit aboard those ambulances and to make those ambulances work," Dawe told CBC News.
"I really and truly don't know where these paramedics are coming from. If the government has them in their back pocket, please let them out, it would help the situation greatly right now."
CBC News asked the Department of Health where the additional staff will come from, what roles they would fill, the capacity of adjacent ambulance services to fill gaps elsewhere and how many additional ambulances to RHAs have.
The Health Department said contingency plans were developed by the regional health authorities and they would be better suited to answer any inquiries relating to operations.
In a statement to CBC News, Central Health communications director Gayle St. Croix said Central Health and Eastern Health have contingency plans in place to help mitigate any job action impact.
"Mutual aid is often provided when ambulances are out of a service area by other private and community operators that are not involved in this job action. This is expected to continue as per regular processes," the statement reads.
"RHAs can also provide support internally when an ambulance is out of a service area, within available human and ambulance resources. The number of additional available ambulances within the RHAs is variable depending on the region, time of day and staff availability. RHAs will assess whether any support can be provided following established processes."
NB
Artificial intelligence use for ambulance calls a concern to paramedics, says association head
Tue, January 17, 2023
Ambulance New Brunswick has started using what it calls a computer-aided dispatch system that alerts paramedics to emergencies using artificial intelligence.
Tue, January 17, 2023
Ambulance New Brunswick has started using what it calls a computer-aided dispatch system that alerts paramedics to emergencies using artificial intelligence.
(Radio-Canada - image credit)
Artificial intelligence now plays a role in how paramedics get dispatched to emergency calls in New Brunswick, and that has many of them concerned about possible hiccups and delays, says the head of the association representing them.
Ambulance New Brunswick last Monday rolled out what it calls a computer-aided dispatch system, which relies on AI and cellular devices to notify paramedics of emergency calls they're being dispatched to.
It's a system that's causing unease and concern among paramedics over the possibility for glitches and malfunctions that could come up in already stressful life and death situations, said Derek Cassista, president of the Paramedics Association of New Brunswick.
"You can tell your phone, 'Hey Siri, take me to A&W', and I'm sure you've had times where that navigation fails or it takes you [on] what you know is the long way around when you think it's the short way around.
"And you know, having an extra-long trip to A&W versus having an extra-long trip to someone's house when they're having a medical emergency obviously are two very different things."
Susie Proulx-Daigle, president of the New Brunswick Union, which bargains on behalf of paramedics, said she also has concerns with the use of the technology.
"Ambulance NB did not make us aware of any changes to the dispatch system, it was brought to our attention by paramedics," Proulx-Daigle said in an email.
"We have some major concerns regarding using text messages as they can be missed, coverage can be poor in various areas. There are several potential issues," she said.
"We feel the radios are the best way to dispatch calls. Any new system with the potential for technical issues, such as interruptions in cell service, can have a major impact on someone's life in an emergency situation."
Radio system will remain as back-up: ANB
The computer-aided dispatch system is known as Intelligent Decision Support and is being delivered by a company called Logis, said Michel Gravel, the director for Ambulance New Brunswick's medical communications management centre.
Having an extra-long trip to A&W versus having an extra-long trip to someone's house when they're having a medical emergency obviously are two very different things - Derek Cassista
In an email, Gravel said the "state-of-the-art" system will improve operational efficiency with a "powerful, automated and customizable dispatch engine, which allows us to tailor the system for our specific needs."
Gravel said feedback from the majority of frontline staff has been "quite positive" since its roll-out.
"Like with any system update we recognize that there will be an adjustment period and during this initial implementation phase, Logis IDS has provided onsite support staff who are resolving any questions or issues as they arise."
Gravel said even with the new system, Ambulance New Brunswick's radio dispatching system will remain in place, along with a series of contingencies that can be transitioned to immediately in the event they are needed.
Gravel said the technology was first implemented two years ago in New Brunswick to improve non-emergency patient transfer services, and provide health-care partners with a platform to request patient transfer bookings online.
Fears of 'isolation'
Cassista said under the previous system, paramedics would get dispatched to emergencies by a dispatcher who communicated instructions to them using radio.
He said the process involved the dispatcher using their own judgment to decide which paramedic was closest to the call, before picking up the radio and alerting them.
However, regardless of who was ultimately sent, all paramedics would be aware of where the call was for and who was going, as they were all tuned into the same radio frequency, Cassista said.
Submitted by Derek Cassista
Under the new system, Cassista said each paramedic is being directed to calls individually, and without the direct knowledge of other paramedics.
"The concern I would say primarily arises from introducing an element of …isolation into the paramedic ranks by using the cell phone too much," Cassista said.
"Whereas before, operating exclusively via radio, everyone can hear what's going on. It feels like if something bad happens to me, if I'm caught in an unsafe environment, then people will have my back on on a quicker response rate."
Cassista said many paramedics also feel like the technology is being introduced unnecessarily at the same time that Ambulance New Brunswick is failing to address shortcomings identified in a 2020 auditor-general's report.
Some of those shortcomings relate to Ambulance New Brunswick's contract with the province, and how that's led to rural areas being under-served compared to urban areas.
"So we move ambulances into these urban centres from rural areas every single day, every single night… because of that operational contract and how the system is structured. It's extremely inefficient," Cassista said.
Hopeful about new technology
Cassista said while he shares in some of the hesitations around the new technology, he thinks adopting it will ultimately be a good thing so long as no issues come up.
So far, he said he hasn't had any issues with the technology himself.
He is positive that once paramedics become more familiar with using it, the concerns they've shared with him will ebb.
"We need more artificial intelligence, we need more information sharing, we need to remove more of the the human error potential," Cassista said.
"So I'm a big proponent of technology. We need innovation like you wouldn't believe. So I'm not, I'm not against this. It's about implementing it properly. Like all good projects, it can live or die in how it's being implemented."
Artificial intelligence now plays a role in how paramedics get dispatched to emergency calls in New Brunswick, and that has many of them concerned about possible hiccups and delays, says the head of the association representing them.
Ambulance New Brunswick last Monday rolled out what it calls a computer-aided dispatch system, which relies on AI and cellular devices to notify paramedics of emergency calls they're being dispatched to.
It's a system that's causing unease and concern among paramedics over the possibility for glitches and malfunctions that could come up in already stressful life and death situations, said Derek Cassista, president of the Paramedics Association of New Brunswick.
"You can tell your phone, 'Hey Siri, take me to A&W', and I'm sure you've had times where that navigation fails or it takes you [on] what you know is the long way around when you think it's the short way around.
"And you know, having an extra-long trip to A&W versus having an extra-long trip to someone's house when they're having a medical emergency obviously are two very different things."
Susie Proulx-Daigle, president of the New Brunswick Union, which bargains on behalf of paramedics, said she also has concerns with the use of the technology.
"Ambulance NB did not make us aware of any changes to the dispatch system, it was brought to our attention by paramedics," Proulx-Daigle said in an email.
"We have some major concerns regarding using text messages as they can be missed, coverage can be poor in various areas. There are several potential issues," she said.
"We feel the radios are the best way to dispatch calls. Any new system with the potential for technical issues, such as interruptions in cell service, can have a major impact on someone's life in an emergency situation."
Radio system will remain as back-up: ANB
The computer-aided dispatch system is known as Intelligent Decision Support and is being delivered by a company called Logis, said Michel Gravel, the director for Ambulance New Brunswick's medical communications management centre.
Having an extra-long trip to A&W versus having an extra-long trip to someone's house when they're having a medical emergency obviously are two very different things - Derek Cassista
In an email, Gravel said the "state-of-the-art" system will improve operational efficiency with a "powerful, automated and customizable dispatch engine, which allows us to tailor the system for our specific needs."
Gravel said feedback from the majority of frontline staff has been "quite positive" since its roll-out.
"Like with any system update we recognize that there will be an adjustment period and during this initial implementation phase, Logis IDS has provided onsite support staff who are resolving any questions or issues as they arise."
Gravel said even with the new system, Ambulance New Brunswick's radio dispatching system will remain in place, along with a series of contingencies that can be transitioned to immediately in the event they are needed.
Gravel said the technology was first implemented two years ago in New Brunswick to improve non-emergency patient transfer services, and provide health-care partners with a platform to request patient transfer bookings online.
Fears of 'isolation'
Cassista said under the previous system, paramedics would get dispatched to emergencies by a dispatcher who communicated instructions to them using radio.
He said the process involved the dispatcher using their own judgment to decide which paramedic was closest to the call, before picking up the radio and alerting them.
However, regardless of who was ultimately sent, all paramedics would be aware of where the call was for and who was going, as they were all tuned into the same radio frequency, Cassista said.
Submitted by Derek Cassista
Under the new system, Cassista said each paramedic is being directed to calls individually, and without the direct knowledge of other paramedics.
"The concern I would say primarily arises from introducing an element of …isolation into the paramedic ranks by using the cell phone too much," Cassista said.
"Whereas before, operating exclusively via radio, everyone can hear what's going on. It feels like if something bad happens to me, if I'm caught in an unsafe environment, then people will have my back on on a quicker response rate."
Cassista said many paramedics also feel like the technology is being introduced unnecessarily at the same time that Ambulance New Brunswick is failing to address shortcomings identified in a 2020 auditor-general's report.
Some of those shortcomings relate to Ambulance New Brunswick's contract with the province, and how that's led to rural areas being under-served compared to urban areas.
"So we move ambulances into these urban centres from rural areas every single day, every single night… because of that operational contract and how the system is structured. It's extremely inefficient," Cassista said.
Hopeful about new technology
Cassista said while he shares in some of the hesitations around the new technology, he thinks adopting it will ultimately be a good thing so long as no issues come up.
So far, he said he hasn't had any issues with the technology himself.
He is positive that once paramedics become more familiar with using it, the concerns they've shared with him will ebb.
"We need more artificial intelligence, we need more information sharing, we need to remove more of the the human error potential," Cassista said.
"So I'm a big proponent of technology. We need innovation like you wouldn't believe. So I'm not, I'm not against this. It's about implementing it properly. Like all good projects, it can live or die in how it's being implemented."
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